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Home > Insurance Division > Bureau of Fraud Deterrence Enforcement Activity
2017 Bureau of Fraud Deterrence Enforcement Activity
Previous Activity: 2016 Enforcement > 2015 Enforcement > 2014 Enforcement
Please Note: P.L. 2013, c. 259 became effective on July 1, 2014.  This law amended the Administrative Procedure Act, R.S. 52:14B-1 et seq. One of the amendments requires all state agencies to post on their websites all non-confidential final agency orders, decisions and opinions. Accordingly, all such final agency orders or decisions in disciplinary actions issued subsequent to July 1, 2014 may be accessed by clicking on the link within the summaries below. Orders or decisions issued on such matters prior to July 1, 2014 are available upon request to the Bureau of Fraud Deterrence.
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March


Executed Consent Orders

Kenneth McCabe, Belleville, NJ
Order #15-54876-04, March 2, 2017
Respondent, Kenneth McCabe, knowingly provided false and misleading information to Progressive Garden State Insurance Company during a Statement of No Loss on October 25, 2015 at 2:02 p.m.  Specifically, Mr. McCabe stated that his 2005 Jeep had not been involved in any accidents since the cancellation of his automobile insurance policy on October 22, 2015, when in fact, he had been involved in an accident on October 25, 2015 at 1:57 p.m.
Civil Penalty: $2,500

Dr. Pauravi N. Raval, Franklin Lakes, NJ
Order #13-51912-24, March 7, 2017
Respondent, Dr. Pauravi N. Raval, knowingly provided false and misleading information by exhibiting a pattern and practice of improperly billing CPT Code 29515 (short leg splinting) to Horizon Blue Cross Blue Shield of New Jersey whenever she provided various sundries of podiatry services to her patients between the years of 2006 and 2013; when in fact no short leg splints or other related castings were provided.  The improper billing allowed Dr. Raval to receive reimbursements to which she was not entitled.
Civil Penalty: $25,000

Yochanan Berkowitz, Livingston, NJ
Order #12-51697-24, March 9, 2017
Respondent, Yochanan Berkowitz, from 2009 through 2011 knowingly submitted claims and/or bills to Horizon Blue Cross Blue Shield of New Jersey for psychotherapy services that were not rendered to numerous patients.
Civil Penalty: $75,000

Krissia Diazamador, Belleville, NJ
Order #15-51401-35, March 3, 2017
Respondent, Krissia Diazamador, knowingly supplied false and misleading statements on an automobile insurance policy application with CURE Auto Insurance Company, dated August 19, 2011 and on subsequent renewal questionnaires through 2005, by failing to disclose an additional resident of the policy address and operator of a policy vehicle.
Civil Penalty: $1,500

Michael Kiszka, East Hanover, NJ
Order #15-51700-03, March 3, 2017
Respondent, Michael Kiszka, knowingly provided false and misleading statements on an auto theft claim to Plymouth Rock Assurance dated January 13, 2015; specifically, by providing false information regarding the purchase price of the vehicle, the actual value, and where the vehicle was purchased.  Respondent also fraudulently notarized the insurance company's vehicle theft affidavit.
Civil Penalty: $5,000

Benesh Madray, Hasbrouck Heights, NJ
Order #16-52129-31, March 3, 2017
Respondent, Benesh Madray, knowingly made a false statement and concealed relevant information on his Progressive Insurance Company application signed/dated on February 16, 2016; specifically, by stating his policy address was in New Jersey, when in fact he was residing and garaging his vehicle in New York.
Civil Penalty: $2,500

Raquel Silva, Elizabeth, NJ
Order #15-51636-44, March 3, 2017
Respondent, Raquel Silva, conspired with Carla Sousa by knowingly submitting false and misleading statements in support of fictitious dental claims to American/Physicians Mutual Insurance Company between June 12, 2014 and December 8, 2014.
Civil Penalty: $5,000

Farah Arece, Jersey City, NJ
Order #15-50941-35, March 2, 2017
Respondent, Farah Arece, knowingly provided false and misleading information to Progressive Garden State Insurance Company during a statement of no loss on January 26, 2015 at 5:34 p.m.  Specifically, Ms. Arece reported that her 2001 Volkswagen had not been involved in any accidents since the cancellation of her automobile insurance policy on January 22, 2015, when in fact, she had been involved in an accident on January 26, 2015 at 8:49 a.m.
Civil Penalty: $2,500

Pablo Chaclan, Paterson, NJ
Order #16-51522-35, March 2, 2017
Respondent, Pablo Chaclan, knowingly concealed relevant information on his Progressive automobile insurance policy with a renewal dated of October 23, 2015, specifically, by not disclosing a regular operator and the garaging location of the insured vehicle.
Civil Penalty: $1,500

Sharon Aviv (L. Aviv Services, Inc.), Jersey City, NJ
Order #15-51258-40, March 21, 2017
Respondent, Sharon Aviv (L. Aviv Services, Inc.), knowingly provided false and misleading information to Travelers Property Casualty Company of America on August 16, 2014.  Specifically, Mr. Aviv failed to disclose the actual scope of work, correct numbers of employees, leasing of employees and the use of subcontractors on a workers compensation insurance plan application for designation of an insurance company and on a truckers supplemental application.
Civil Penalty: $5,000

Cynthia Garcia, Clifton, NJ
Order #16-50335-35, March 21, 2017
Respondent, Cynthia Garcia, knowingly provided false and misleading information to CURE Auto Insurance Company by failing to disclose a licensed household operator on an automobile insurance application and renewal questionnaires dated November 21, 2013, September 5, 2014 and August 31, 2015.
Civil Penalty: $1,500

Brionna Green, Maplewood, NJ
Order #16-50870-35, March 21, 2017
Respondent, Brionna Green, knowingly provided materially false information on November 5, 2015 during her recorded loss report to Progressive Garden State Insurance Company by alleging the damage to the 2016 Ford Fusion occurred on November 5, 2015, when in fact, it occurred on November 4, 2015, prior to the policy inception date.
Civil Penalty: $1,500

Russell Gonzalez, New York, NY
Order #15-54495-31, March 28, 2017
Respondent, Russell Gonzalez, did knowingly provide materially false information on an initial application with CURE Auto Insurance Company on December 4, 2014 and February 5, 2015, by falsely claiming he resided at a Newark address in New Jersey, when in fact, he resided at an address in New York, New York.
Civil Penalty: $2,500

Gennifer Flaxman, Voorhees, NJ
Order #14-51512-12, March 21, 2017
Respondent, Gennifer Flaxman, did knowingly provide materially false information on a homeowners policy application with Hanover Insurance Company by falsely submitting a "statement of replacement cost" for Inland Marine Coverage of jewelry, knowingly submitting a false police report in an attempt to secure insurance coverage from a mysterious disappearance of a bag with jewelry and knowingly submitting a false claim for lost property by preparing a false personal property worksheet.
Civil Penalty: $5,000

Thomas Medford, Bridgeport, NJ
Order #15-53101-35, March 7, 2017
Respondent, Thomas Medford, did provide a materially false statement to CURE Auto Insurance Company in obtaining an automobile insurance policy dated April 10, 2015 by knowingly failing to disclose his true marital status and another individual who was a resident operator in his household of a vehicle registered to him.
Civil Penalty: $1,500

Stephanie Cochran, Burlington, NJ
Order #16-50723-41, March 2, 2017
Respondent, Stephanie Cochran, did knowingly provide materially false information on an application for short term disability insurance with Mutual of Omaha dated May 25, 2015, by failing to disclose her medical history.
Civil Penalty: $1,500

Kevin M. Ford, Brigantine, NJ
Order #15-53901-35, March 9, 2017
Respondent, Kevin M. Ford, did knowingly provide a materially false statement to Progressive Garden State Insurance Company by falsely claiming the time of the accident on May 2, 2013, as occurring after he added collision and comprehensive coverage, when in fact, the accident happened prior to him adding these coverages.
Civil Penalty: $3,000

Terri L. Hansen, Heislerville, NJ
Order #16-52673-35, March 30, 2017
Respondent, Terri L. Hansen, did provide materially false statements to CURE Auto Insurance Company in obtaining and renewing an automobile insurance policy dated March 6, 2014, by knowingly failing to disclose that another individual was a resident in her household and an operator of a vehicle registered to her.
Civil Penalty: $1,500

 
February


Executed Consent Orders

Jaclyn Rizzi, Elmwood Park, NJ
Order #15-52078-04, February 1, 2017
Respondent, Jaclyn Rizzi, knowingly provided false and misleading information when she submitted a claim for pre-existing vehicle damage to Progressive Garden State Insurance Company on April 7, 2015.  The pre-existing vehicle damage was previously denied by State Farm Insurance Company on January 29, 2015.
Civil Penalty: $3,500

Moheb Gobran, Boynton Beach, FL
Order #16-52582-41, February 1, 2017
Respondent, Moheb Gobran, knowingly provided false and misleading statements to Disability Management Services/AXA Equitable Insurance Company on a Total Disability Statement signed/dated on November 3, 2014, by stating he had not performed any work since date of loss May 27, 2014 to present, when in fact he was working during this time period.
Civil Penalty: $17,500

Irma Gamonal, Paterson, NJ
Order #16-50200-35, February 17, 2017
Respondent, Irma Gamonal, knowingly provided false and misleading information to Progressive Garden State Insurance Company on an automobile insurance application dated March 15, 2012, by failing to list a licensed household resident.
Civil Penalty: $1,500

Jacqueline Stanek, New Providence, NJ
Order #15-54502-35, February 17, 2017
Respondent, Jacqueline Stanek, knowingly provided false and misleading statements to Progressive Garden State Insurance Company on June 28, 2012.  Specifically, Jacqueline Stanek failed to disclose an additional resident in her household and an operator of her 2012 Ford Fusion.
Civil Penalty: $1,500

Andrea Cole, Gloucester City, NJ
Order #15-53594-35, February 13, 2017
Respondent, Andrea Cole, did provide a materially false statement to Plymouth Rock Assurance Company in obtaining an automobile insurance policy dated January 16, 2015, by knowingly failing to disclose that there was a resident in her household with a suspended New Jersey driver's license who was an operator of a vehicle registered to her. Respondent, Andrea Cole, did provide a materially false statement to Plymouth Rock Assurance Company in obtaining automobile insurance policy dated August 26, 2015, by knowingly filing false or misleading information in an application for insurance.
Civil Penalty: $1,500

Sarah Manzo, Bayville, NJ
Order #15-53979-35, February 7, 2017
Respondent, Sarah Manzo, did provide a materially false statement to CURE Auto Insurance Company in obtaining automobile insurance dated May 11, 2015, by knowingly failing to disclose an additional resident in her household and an operator of a vehicle registered to her.
Civil Penalty: $1,500

William Petruccelli, Woodland Park, NJ
Order #16-55241-03, February 17, 2017
Respondent, William Petruccelli, knowingly provided false and misleading statements on an auto theft claim to Foremost Insurance Company, specifically, by stating that his vehicle, an antique 1972 Chevelle, was stolen on August 27, 2007 from his residence, when in fact, it was not stolen.
Civil Penalty: $5,000

Ramiro G. Vargas, Jr., Elizabethport, NJ
Order #16-51880-08, February 28, 2017
Respondent, Ramiro G. Vargas, Jr., purposely set his own 2015 Ford Explorer on fire on October 31, 2015, then falsely requested during a formal claims process that Allstate Insurance pay for the fire damage.  These false statements include: 1. The false statement to Elizabeth Police Department Officer Vincent Flatley on October 31, 2015 at the fire scene, as documented in the Elizabeth Police Department first responder report.  This report was then submitted by Mr. Vargas to Allstate to further his false fire claim.  2. The false Affidavit of Vehicle Fire dated November 7, 2015, submitted to Allstate.  3. The false recorded statement dated November 11, 2015 to Allstate.  4. A false letter of complaint from Mr. Vargas to Allstate dated December 1, 2015.  5. The false Examination Under Oath testimony given on January 11, 2016 by Mr. Vargas to Allstate.  6. A false letter of protest from Mr. Vargas to the New Jersey Department of Banking and Insurance Ombudsman dated March 23, 2016.
Civil Penalty: $5,000

 
January


Executed Consent Orders

Ibrahim Muheisen, Elmwood Park, NJ
Order # 14-50540-35, January 24, 2017
Respondent, Ibrahim Muheisen, knowingly provided false and misleading information to 21st Century Centennial Insurance Company on an automobile application dated December 1, 2011 and subsequent renewals dated June 1, 2012 through December 1, 2014.  Specifically, he failed to list additional resident drivers.
Civil Penalty: $1,500

Byron Espinoza, Newark, NJ
Order #15-50090-06, January 12, 2017
Respondent, Byron Espinoza, knowingly provided a fraudulent invoice dated November 4, 2014 to Great Lakes Reinsurance Company in support of a claim.  Specifically, he submitted a tow bill for $5,600, when in fact he paid $1,930 for the tow.
Civil Penalty: $3,000

Anthony Antonellis, Wyckoff, NJ
Order #15-52484-35, January 12, 2017
Respondent, Anthony Antonellis, knowingly provided false information on an automobile application dated April 29, 2015 at 4:54 PM to Esurance Insurance Company.  Specifically, stating no one had an accident, when in fact the loss occurred at 3:47 p.m. on April 29, 2015, which was misrepresented to Esurance as an attempt to gain coverage for the third party insurance claims.
Civil Penalty: $1,500

Donald Johnson, Stewartsville, NJ
Order #15-50810-35, January 20, 2017
Respondent, Donald Johnson, did provide materially false statements to CURE Auto Insurance Company in adding a vehicle and renewing an automobile insurance policy dated February 7, 2011 by knowingly failing to disclose that another individual was the registered owner and operator of an insured vehicle.
Civil Penalty: $1,500

Jung Ok Choi, Morganville, NJ
Order #11-23106-18, January 24, 2017
Respondent, Jung Ok Choi, did knowingly provide a false written statement to American European Insurance Group in support of a claim, by submitting a fraudulent invoice from State Machinery, LLC, in the amount of $21,080 for spare machine parts.
Civil Penalty: $5,000

Stephanie Clegg, Plainfield, NJ
Order #15-54138-35, January 24, 2017
Respondent, Stephanie Clegg, did knowingly provide a materially false statement to New Jersey Manufacturers Insurance Company on November 15, 2014 and June 15, 2015, by failing to disclose that her insured vehicle was garaged at a location other than the policy address.
Civil Penalty: $5,000

Luis Negron, Camden, NJ
Order #15-52074-35, January 12, 2017
Respondent, Luis Negron, did provide materially false information to Progressive Insurance Company regarding an automobile insurance policy dated May 13, 2014 by knowingly failing to disclose that another individual was a driver of an insured vehicle listed on that policy with a suspended New Jersey driver's license, and that the vehicle was garaged at a location other than the policy address.
Civil Penalty: $1,500

Mildreya C. Kirby, Springfield, MA
Order #15-54773-04, January 20, 2017
Respondent, Mildreya C. Kirby, did provide a materially false statement to Progressive Group of Insurance Companies by falsely reporting the time of the accident on November 12, 2015 as occurring after she added collision, comprehensive, rental and roadside assistance coverage, when in fact, the accident happened prior to her adding these coverages.
Civil Penalty: $2,500

 
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